RN Case Manager
Santa Barbara,, California
Santa Barbara Cottage Hospital

Job Opportunity: Case Manager (Registered Nurse)

Location: Santa Barbara, California
Employment Type: Travel/Contract
Contract Length: 13 weeks

Job Summary

Seeking an experienced Registered Nurse to function as a Case Manager responsible for utilization management, quality assurance, and discharge planning in an acute hospital setting. The role involves care coordination, ensuring optimal patient outcomes, cost management, and high customer satisfaction. This position requires active hands-on experience in inpatient care coordination, discharge planning, and post-acute clinical payer authorization.

Work Environment & Schedule

• Acute hospital setting with some long-term acute care, rehab, and skilled nursing involvement
• Average daily census: 30 patients
• Visits per day: 18
• Beds: 32
• Patient age group: Adults
• Shift: Monday through Friday, 5 days a week, 7:30 AM to 4:00 PM (weekends off)
• Scheduling type: Block schedule
• Float requirement: Must be willing to float to other units
• No on-call required
• Documentation system: EPIC

Required Qualifications

Education

• Associate of Science in Nursing / Associate Degree in Nursing

Licenses & Certifications

• Valid Registered Nurse (RN) license in California
• Basic Life Support (BLS) certification issued by the American Heart Association
• Tech Cert Verification - National
• State License 1 Verification
• NURSYS Verification (RN, LPN/LVN, AP)
• Harassment Prevention Training Certificate
• Orientation Safety Manual Acknowledgement

Experience

• Minimum 2 years of direct patient care experience in an acute care setting
• Minimum 2 years of case management experience, including Registered Nurse Case Manager (RNCM) experience
• Case management experience within the last year
• Hands-on inpatient care coordination experience
• Post-acute clinical payer authorization experience
• Utilization management and utilization review experience (including InterQual)
• Discharge planning experience
• Medical coding knowledge
• Experience in an acute care setting

Key Responsibilities

• Utilization management and quality assurance
• Discharge planning and care coordination
• Post-acute clinical payer authorization
• Use of InterQual Criteria and Milliman Guidelines for utilization review
• Conduct admission criteria reviews, appeals and denials, concurrent and retrospective reviews, and continued stay reviews
• Ensure compliance with CMS, CPT coding, Department of Health, DRG, HEDIS, HIPAA, ICD-10, NCQA, OSHA, The Joint Commission, and Worker’s Compensation regulations

Skills & Abilities

• Excellent organizational and analytical skills
• Ability to make independent decisions and apply effective problem-solving methods
• Strong interpersonal skills with professional, objective, and value-oriented communication
• Effective oral and written communication skills related to case management functions

Required Knowledge Areas

• Case Management/Utilization Review
• Admission Criteria
• Care Coordination
• Discharge Planning
• Appeals and Denials
• Medical Necessity
• Regulatory compliance including CMS, HIPAA, OSHA, and The Joint Commission

Additional Requirements

• Must complete facility-specific job description and safety manual acknowledgements
• Background checks covering all locations lived/worked/schooled in the past 7 years
• Negative 10-panel drug screen within 30 days of start
• Physical exam and immunizations per facility policy (including TB test, flu vaccination or declination, and other standard vaccines)
• Fit testing for respirators if applicable
• Professional references may be required

Notes

• High cost of living in the area; candidates should research before applying
• No first-time travelers accepted for this role

This position is ideal for an experienced RN Case Manager with strong acute care coordination skills looking for a travel contract in California.